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Saturday, June 14, 2014

Gastric Bypass- The Easy Way Out?! Part Two

Last post, we started talking a little about the underside of the proverbial gastric bypass iceberg. The largest part. The part that no one sees. If you missed the first of this two parter, get caught up by clicking here.

Today, I want to carry on and let you know what work and elements go in to the early post operative period, by describing a little of what it was like for me.

Before surgery, I did so much research, and I really got to feel I knew what to expect.
I know that I felt much more settled, after I'd made lots of changes, and satisfied myself that this was the choice to be making.

I'd had my food funeral, I'd gone through my two weeks of Opti-fast, and two days of clear fluids.
I'd filled my prescriptions, packed my bags. I'd made up a duotang with everything my mother in law was going to need in the coming weeks while she came in and looked after my kids for me. (What a wonderful gift of both her time and resources.)

There is something pretty sobering when you get to the part that you have to talk with your husband about what happens if for some reason you don't make it through surgery, but we had that talk too.

I was ready.

Ready to jump into the unknown and take all the changes that came with it.

I happened to have a morning appointment for surgery, so I reported to day surgery unit, and checked in. From there I have made ready for surgery, gown, hat, IV and all.
My husband could only go so far with me, so we parted ways.
I didn't have long to wait though. I went through to the OR, met my surgeon for the first time and transitioned to the operating table. Not long after that they put the lights out.

Waking up brought some fun challenges. I had some pain to manage, some from gas left over inside, and some from the re-routing of my intestines. We are expected to get up and walking shortly after surgery, so that the gas will work its' way out, and to prevent blood clots, so that is number one on our to-do list. We get to race around the halls like snails in agony. I'm thinking I looked like one, anyway :)

The IV wasn't too bad to deal with, but I did find myself very nauseous. We were expected to transition from IV to taking fluids by mouth, and we had medicine cups to take fluids in. Imagine getting to pour all your efforts in to taking these tiny cups, and feeling completely full. It's complete culture shock.

That isn't all though. We get to shoot ourselves with a blood thinner shot for about a week after surgery. After a couple of days you get to go home and the real work begins.

The clinic wants you tracking your intake, walking, taking your vitamins, and working on getting as much protein as possible, in the form of protein shakes. They also want you getting 2 litres of fluid per day; going at a pace of about 15 ml. per ten minutes. Sip. Sip. Sip. It takes up a LOT OF TIME. It's really all you can think about for quite some time. It's a time that is taken over also by a need to continue dealing with your food issues, and handling any head hunger, because you're not feeling physical hunger just yet.

The cup on the right holds a little more than the amount we drank at a time early post op on full fluids.

The bowl on the right is a one cup rice bowl, my now typical meal size at a year out.

Moving around can be challenging, but they give you decent medication for pain relief.
For the first 6-8 weeks, they have lifting restrictions on you, nothing more than ten pounds.
You also refrain from doing strenuous exercise for that same period of time while you recover. But that's okay, you're busy with walking, and learning to eat again anyway.

There were clinic appointments early out, and we were well looked after, with some early opportunity to see our weight going down, and this was motivating. Motivation is something we need, because for quite a while the diet is kind of depressing. We spent two (or more) weeks on Opti-fast, and after surgery we need to be kind to our newly healing pouch. That means a gradual and slow reintroduction of foods. The first two weeks were full fluids. Are you tracking with me here that this is a minimum of a month of fluids? For those two weeks, our meals consist of 1/4 of a cup of fluid, and over that time, we stretch ourselves to 1/2 a cup. It doesn't sound like much,but seriously, most of us have to fight to get it in.

Imagine two more weeks of milk, low fat strained cream soup, and pudding, or sugar free jello, along with protein shakes.

Weeks three, four and five are much for interesting. After so long on fluids, you almost want to cry for joy when you re-introduce low fat cottage cheese, baby food textured meat, and egg salad, with no celery or onion. Even oatmeal and cream of wheat are pure heaven. But you still can't get much in volume wise. The portion sizes kind of look ridiculous to the average eater, and even to us. We can't believe that an amount that small would be satisfying, but there it is.
Week four brings back peanut butter. Mmmm pure heaven.
Week five, you get to reintroduce lean deli meats, low fat cheese, and other meats. Bread products come back then as well. But only toast and things that break down well.

It isn't til about week 6 that bread itself comes back. Bread is where I found one of my problem foods. Sits like lead. Chest pain ensues. it's a bad deal. But as long as I respect my limits, usually things go pretty well.

After that what?

Week six begins the diet for life. We pretty much adopt a low fat, high protein, low sugar type of diet, that keeps the healthy stuff a priority. We're supposed to stay away from the sugar laden foods, that pre-op used to call us with intensity of a blinking neon sign. With good reason. Our new systems can not process it the way it could before we were altered. Should we overindulge, we have all sorts of lovely experiences, that could include dumping. Dumping is kind of like having rapid onset flu symptoms that last a couple of hours. If you're lucky, you bring up what offended. If not, you get to wait for it to work its' way through your system and exit quickly, to put it delicately. Best thing you can do is lie down and sleep it off.

It takes a while to reintroduce foods. You become careful about trying foods for the first time post-op any where other than home. It gets better though. After a big learning curve, you end up figuring out what you tolerate. You figure out what you don't.... but sometimes your delicate system decides to play tricks on you. So you learn to take a protein bar with you almost everywhere you go and not try anything you suspect might cause you trouble. Especially if you need to drive home ;)

On going, it's important to never forget where we came from, to track our food and exercise, and to keep it up for life. We proceed knowing that gastric bypass is just a tool; the one that made the rest of our tools work. The tool that gave us a fighting chance.

So, when I began this series, did you have any idea that this much went into it all?
Or did you think that the awesome 'before and after' shots were really all there was to the story?

To counter balance this, I need to tell you it's all worth it.
I lost 100 pounds in 6 months, and the non-scale victories started wracking up. (click here if you missed my list of favourites) You can't not feel motivated to keep up with all the necessary steps when you are getting immediate and marked results like that.
The 'flashing sign' demanding you eat all of your trigger foods is turned off for a while, and it is blessed relief, I am telling you. It didn't stay off forever, but it gave me a fighting chance for long term change.

I hear stories all the time in gastric bypass circles that people's success is shot down by those crying foul that we took the 'easy way out'.The effective way out, maybe, but not easy. The farther out I go in this process, the more I realize that that 'easy way out' is really code for 'willing to pay a higher and more permanent price than anyone else for a chance to take back their health'.
In that case, I take it as a compliment.

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About Me

I am a Homeschooling SAHM mom of five eccentric kids. Life has taken my family some unusual, unexpected places, but the roller coaster ride has been worth it. There is almost always something unusual going on at my house. Even so, I strive to see the humour in every situation, regardless of how long it takes me to find it.

Some of the topics close to my heart are homeschooling, special needs accommodations in homeschooling and parenting, large family living, pregnancy/infant loss, weight loss surgery, and weight management issues.